Neuromyofascial model of human body
In manual therapies an immediate “melting” response of the tissues is often felt under the hands of the practitioner.
How can we explain this “tissue release”?
Many bodywork modalities focus their treatment on the fascial tissues. Fascia is a matrix of soft tissue connective tissues surrounding and protecting all the body structures (muscles, bones, organs, nervous system).
A pure biomechanical model cannot explain the plasticity of the fascial network because the forces applied during manual manipulations are not strong enough to produce any deformation of the tissues.
So what are we doing in our manual manipulations?
Recent findings (1) show that fascia is rich of interstitial receptors that work as mechanoreceptors, which means that they respond to the mechanical stimuli of tension, compression and shear stress. This large network of mechanoreceptors is connected to the autonomic nervous system.
First, sensory input from these receptors can trigger a change of the local blood supply. Second, their stimulation can influence the extrusion of plasma from blood to the extracellular matrix. Such a change in the local fluid dynamics means a change of viscosity of the matrix, which means that the fascial tissues become more fluid. Third, the interstitial mechanoreceptors can trigger an increase in the vagal tone which results in an overall neuromuscular relaxation.
So our fascial network is not simply a viscoelastic material but it is a more complex neuromyofascial system that can change its shape. Therefore slow deep pressure strokes in manual therapies are able to activate a fascial tissue response through autonomic nervous connections. We can say that the fascial web is a self-regulating system.
Fascia is alive!
As consequence a new bodywork therapeutic relationship is required: the practitioner is no longer a ‘master technician who fixes physical body problem,’ but rather, is a facilitator.
The massage practitioner assists the patient in this process of re-modeling of the fascial web. The recipient of manual manipulations often feels sensations of warmth, lightness, spaciousness and streaming. All these bodily sensations are interoceptive. Interoception is the sensing of the physiological condition of our body.
It is “how I feel”.
These sensations are triggered by stimulation of the interstitial fascial mechanoreceptors that send the sensory information to the insular cortex, the region of the brain that integrates all this information. Awareness of our internal physiological state can help to modulate our behaviors. Recent studies (2) show that somatoemotional disorders like anxiety and depression are related to altered interoceptive states.
So now we can try to explain the changes that we observe and feel in therapeutic bodywork sessions. Myofascial and visceral manipulations trigger interoceptive sensations that stimulate the re-organization of the body. Body is no longer seen as a machine. Human body is a complex self-regulating system that can change its form. Body awareness (interoception) is the basis for this change which gives general sense of well-being.
In all the Traditional East Asia Medicines (TEAM), the human body is treated as a whole communication network. The “energy lines” are communication pathways.
Any blockage in this information network will cause disease and pain. Some researchers have pointed out the connection between myofascial tissues and the Traditional Chinese Medicine (TCM) meridians (3,4). It would appear that the energetic system of TEAM corresponds to our neuromyofascial web, although further research is needed to investigate this relationship.
At Pakua Integrative Health Clinic many therapeutic bodywork modalities are offered in the Detox and Chronic Pain Management programs, which utilize this intimate relationship.
Chi Nei Tsang and Karsai Nei Tsang focus on visceral manipulations. Structural Bodywork, Gua Sha and Tok Sen focus on the myofascial meridians.
Tok Sen is a unique healing therapy developed in northern Thailand (Lanna) over 5000 years ago (5). Tok Sen literally means to clear the energy lines (Sen in the traditional Thai medicine). It uses vibration to release tensions along the myofascial lines.
Gua Sha is defined as instrument-assisted unidirectional press stroking of the body surface that intentionally creates transitory therapeutic petechiae or bruising, representing extravasion of blood in the skin. Gua from Chinese is to “scrape”. Sha means “blood stasis”. Thus, Gua Sha is indicated for myofascial pain. In TEAM pain represents stasis.
“No free-flow=pain; free flow=no pain” (6).
In acknowledging this important connection between the neuromyofacial web and the energetic systems of TEAM we can include eastern techniques in fascia-oriented therapies.
Stefano Beconcini, MSc Physics, Therapeutic Bodywork
1) Schleip R., 2003,”Fascial plasticity: a neurobiological explanation”
2) Paulus M., 2010, “Interoception in anxiety and depression”
3) Langevin H., Yandow J.,2002, “relationship of acupuncture points and meridians to connective tissue planes”
4) Dorsher P.T., 2009, “Myofascial referred pain data provide physiologic evidence of acupuncture meridians”
5) Mantak Chia,2012, “Chi Nei Tsang Healing Harmony”
6) Nielsen A., 1995, “Gua Sha: a traditional technique for modern practice”